Abstracts

Rationale: The detrimental effect of frequent early seizures on intelligence quotient (IQ) of children is a significant clinical issue. The decision to pursue surgical treatment must balance the potential benefit of seizure control with the potential impact and probability of cognitive decline. Patients who may benefit from epilepsy surgery might be deterred from surgical evaluation due to concerns of postoperative IQ decline.Methods: We analyzed the pre and postoperative neuropsychological outcomes of children who underwent epilepsy surgery to determine if epilepsy surgery impacts cognition. The Wechsler Intelligence Scales were administered pre-operatively and least 1 year post-operatively in all children. A chart review was done and demographic data, seizure type, seizure frequency, anti-epileptic medications, duration of seizures, neuroimaging, type of surgery and pathology was recorded. Neuropsychological data was compared pre and post-operatively and included full scale, verbal and performance intelligence quotients (FSIQ, VIQ, PIQ) and the child behavioral checklist (CBC). Results: 59 patients with epilepsy surgery who had pre and post-operative neuropsychological evaluations were included in the study. Age of onset of seizures ranged from 1 month to 16 years. The mean duration of seizures prior to surgery was 5.9 years. Types of surgery included temporal lobe resection (n = 20), extratemporal and multilobar resection (n = 38) and corpus callosotomy (n=1). No significant change in FSIQ, VIQ, PIQ or CBC was demonstrated on a group level. Lateralization, type of surgery, age at surgery, sex, and presurgical IQ did not affect outcome. Conclusions: Epilepsy surgery in children and adolescents offers a good prognosis for seizure control and does not have a significant impact on IQ.